BackgroundDespite a variety of efficient and cost-effective antihypertensive medication, hypertension remains a serious health and economic burden. High consumption of cardiovascular drugs in the Slovak Republic does result neither in better hypertension control nor in significant decrease in cardiovascular mortality. At the same time, Slovakia has alarmingly low patients’ adherence to medication intake. Studies have shown the efficiency of short messaging service (SMS) reminders to improve patients’ adherence and health outcomes at low costs. Since SMS is popular among Slovaks, this approach may be feasible also in Slovakia. The primary objective is to assess if daily SMS reminders of antihypertensive medication intake provided by pharmacists in addition to the standard pharmaceutical care increase the proportion of adherent older hypertensive ambulatory patients.MethodsThe SPPA trial is a pragmatic randomized parallel group (1:1) trial in 300 older hypertensive patients carried out in community pharmacies in Slovakia. Trial pharmacies will be selected from all main regions of Slovakia. Trial intervention comprises daily personalized SMS reminders of medication intake embedded into usual pharmaceutical practice. The primary outcome is a combined adherence endpoint consisting of subjective self-reported medication adherence via the eight-item Morisky Medication Adherence Scale (MMAS-8) and objective pill count rate. Secondary outcomes include: change in the MMAS-8; comparison of adherence rates using pill count; change in systolic blood pressure; and patient satisfaction. Also, direct treatment costs will be evaluated and a cost-effectiveness analysis will be carried out.DiscussionThe SPPA trial engages community pharmacists and mobile health (mHealth) technologies via evidence-based pharmaceutical care to efficiently and cost-effectively addresses current main healthcare challenges: high prevalence of hypertension; overconsumption of cardiovascular medicines; low adherence to medication treatment; and resulting uncontrolled blood pressure. The results may identify new possibilities and capacities in healthcare with low additional costs and high value to patients.Trial registrationClinicalTrials.gov, NCT03105687. Registered on 07 March 2017.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2063-8) contains supplementary material, which is available to authorized users.

Part 1: ConferenceInternational audienceThe popularity of NoSQL databases keeps growing and more companies have been moving away from relational databases to non-relational NoSQL databases. In this paper, the partitioning of a relational data model of an inquiry system into semi-structured and relational data for storage in both SQL and NoSQL databases is shown. Furthermore, the CAP theorem will be applied to categorize the storing of the correct parts of the model into their corresponding databases. As a result of these reorganizations and the introduction of additional histogram data, overall performance improvements of about 93% to 98% are achieved

A long tradition of research in WEIRD (Western, Educated, Industrialized, Rich, Democratic) countries has investigated how people weigh individual welfare versus group welfare in their moral judgments. Relatively less research has investigated the generalizability of results across non-WEIRD populations. In the current study, we ask participants across nine diverse cultures (Bali, Costa Rica, France, Guatemala, Japan, Madagascar, Mongolia, Serbia, and the USA) to make a series of moral judgments regarding both third-party sacrifice for group welfare and first-person sacrifice for group welfare. In addition to finding some amount of cross-cultural variation on most of our questions, we also find two cross-culturally consistent judgments: (1) when individuals are in equivalent situations, overall welfare should be maximized, and (2) harm to individuals should be taken into account, and some types of individual harm can trump overall group welfare. We end by discussing the specific pattern of variable and consistent features in the context of evolutionary theories of the evolution of morality.

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